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Conflict Of Interest Declaration Form
I need a Conflict of Interest Declaration Form for a Danish pharmaceutical company's board members and senior executives, with special attention to research funding relationships and clinical trial involvement.
1. Personal Information: Basic information about the declarant including full name, position, department, and employee ID
2. Declaration Period: Specification of the time period this declaration covers and frequency of required updates
3. Financial Interests: Declaration of any financial interests in other organizations, including shareholdings, investments, and business ownership
4. Outside Employment/Activities: Details of any external employment, consultancy, board positions, or voluntary roles
5. Family Interests: Disclosure of relevant interests held by immediate family members that could create conflicts
6. Gift and Hospitality Declaration: Details of any significant gifts or hospitality received in connection with professional role
7. Certification: Formal declaration of truthfulness and completeness of the information provided, with signature and date
1. Academic/Research Interests: For academic or research institutions, declaration of research grants, academic collaborations, and intellectual property interests
2. Professional Association Memberships: For professional roles where association memberships might influence decision-making
3. Procurement Involvement: For employees involved in procurement decisions, specific declarations regarding supplier relationships
4. Political Activities: For public sector roles or sensitive positions, declaration of political affiliations or activities
1. Schedule A: Detailed Financial Holdings: Detailed list format for declaring specific financial interests including company names, ownership percentages, and values
2. Schedule B: Family Members Declaration: Template for listing relevant family members and their interests that could create conflicts
3. Schedule C: Gift Register: Detailed log for recording gifts and hospitality received, including dates, values, and sources
4. Appendix 1: Guidelines for Completion: Detailed instructions and examples for completing each section of the form
5. Appendix 2: Relevant Legal Provisions: Summary of key Danish legal requirements regarding conflicts of interest
Authors
Material Interest
Close Family Member
Related Party
Financial Interest
Professional Association
Outside Employment
Declarant
Company
Competing Entity
Gift
Hospitality
Substantial Shareholding
Business Relationship
Board Position
Commercial Interest
Intellectual Property Rights
Decision-Making Authority
Professional Duties
Significant Influence
Personal Benefit
Affiliated Entity
Disclosure Period
Immediate Family
Material Transaction
Declaration Statement
Financial Interests
Outside Employment
Family Relationships
Professional Associations
Gift and Hospitality
Confidentiality
Data Protection
Compliance Obligation
Update Requirements
Verification
Consequences of Non-Disclosure
Review Process
Acknowledgment
Certification
Record Keeping
Reporting Changes
Declaration Period
Signature and Date
Public Administration
Financial Services
Healthcare
Education
Research and Development
Professional Services
Manufacturing
Retail
Technology
Non-Profit Organizations
Energy
Construction
Pharmaceuticals
Legal Services
Consulting
Legal
Compliance
Human Resources
Finance
Procurement
Executive Leadership
Board of Directors
Research and Development
Investment
Public Relations
Ethics Committee
Audit
Risk Management
Corporate Governance
Operations
Board Member
Executive Director
Chief Executive Officer
Department Head
Project Manager
Procurement Officer
Research Director
Financial Controller
Investment Manager
Senior Consultant
Public Official
Clinical Director
Ethics Officer
Legal Counsel
Human Resources Director
Grant Administrator
Academic Researcher
Senior Administrator
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